A PCR technique to differentiate pathogenic enteric Escherichia coli strains in a field setting was evaluated. Among 76 children with acute diarrhea, this technique identified 12 children (16%) with enterotoxigenic E. coli, 6 (8%) with enteropathogenic E. coli, and 1 (1%) with enteroinvasive E. coli infection. Compared with the conventional assays, the PCR method proved to be simpler, more rapid, and inexpensive and therefore suitable for application in a developing-country field setting. Diarrheal disease remains a major public health problem in developing countries (25). Escherichia coli strains are among the most important bacterial causes of childhood diarrhea. At least five categories of diarrheagenic E. coli strains are recognized on the basis of distinct epidemiological and clinical features, specific virulence determinants, and association with certain serotypes (12, 15). Because of the costly and laborintensive diagnostic procedures, the epidemiology of E. coli infections remains obscure in many parts of the world. This study was undertaken to evaluate the application of a PCRbased test to differentiate E. coli isolates and determine their distribution among children with and without diarrhea. The study was conducted at Hospital Infantil of the Federal University of Bahia in Salvador de Bahia, Brazil. From 1 June to 31 August 1993, all children under 5 years of age with acute diarrhea who were brought to the hospital ambulatory clinic in the afternoon, Monday through Friday, were enrolled in the study. Two rectal swabs were collected from each child, placed in Cary-Blair transport medium, and processed within 4 h. One swab was processed by routine microbiological and biochemical tests to identify E. coli, Salmonella spp., Shigella spp., and Campylobacter jejuni, while the second swab was stored in 2 ml of phosphate-buffered saline (pH 7.4) at 4ЊC until tested for rotavirus by enzyme immunoassay (EIA) (LMD Laboratories, Inc., Carlsbad, Calif.). Fecal samples and/or rectal swab specimens were obtained for detection of Cryptosporidium parvum by enzyme-linked immunosorbent assay (ELISA) (Alexon Inc., Sunnyvale, Calif., and LMD Laboratories, Inc.). Three to six lactose-fermenting colonies and up to three lactose-negative colonies from each child were selected from MacConkey plates to be tested by conventional and PCR procedures. A total of 239 isolates were obtained from the 76 children and stored on tryptic soy agar (Difco Laboratories, Detroit, Mich.) gridplates for later testing by reference virulence assays. In addition, 43 isolates from 16 children without diarrhea were tested as controls.